Healthcare Provider Details

I. General information

NPI: 1790463313
Provider Name (Legal Business Name): MANAL CHOUDHRY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6532 N US HIGHWAY 441
COCONUT CREEK FL
33073-3624
US

IV. Provider business mailing address

2305 RABBIT HOLLOWE CIR
DELRAY BEACH FL
33445-6691
US

V. Phone/Fax

Practice location:
  • Phone: 754-256-4085
  • Fax:
Mailing address:
  • Phone: 561-859-4652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN32184
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: